Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation

experience at a Japanese single institution

Manaka Tagaya, Daiji Yoshikawa, Yoshinori Sugishita, Fumi Yamauchi, Takehiro Ito, Tomohito Kamada, Masataka Yoshinaga, Daisuke Mukaide, Wakaya Fujiwara, Hiroatsu Yokoi, Mutsuharu Hayashi, Eiichi Watanabe, Junichi Ishii, Yukio Ozaki, Hideo Izawa

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 %) patients were treated with NOACs and 109 (60 %) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.

Original languageEnglish
Pages (from-to)957-962
Number of pages6
JournalHeart and Vessels
Volume31
Issue number6
DOIs
Publication statusPublished - 01-06-2016

Fingerprint

Anticoagulants
Atrial Fibrillation
Prescriptions
Hemorrhage
Warfarin
Intracranial Hemorrhages
Embolism
Oral Administration
Logistic Models
Stroke
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Tagaya, Manaka ; Yoshikawa, Daiji ; Sugishita, Yoshinori ; Yamauchi, Fumi ; Ito, Takehiro ; Kamada, Tomohito ; Yoshinaga, Masataka ; Mukaide, Daisuke ; Fujiwara, Wakaya ; Yokoi, Hiroatsu ; Hayashi, Mutsuharu ; Watanabe, Eiichi ; Ishii, Junichi ; Ozaki, Yukio ; Izawa, Hideo. / Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation : experience at a Japanese single institution. In: Heart and Vessels. 2016 ; Vol. 31, No. 6. pp. 957-962.
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title = "Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation: experience at a Japanese single institution",
abstract = "New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 {\%}) patients were treated with NOACs and 109 (60 {\%}) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.",
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Tagaya, M, Yoshikawa, D, Sugishita, Y, Yamauchi, F, Ito, T, Kamada, T, Yoshinaga, M, Mukaide, D, Fujiwara, W, Yokoi, H, Hayashi, M, Watanabe, E, Ishii, J, Ozaki, Y & Izawa, H 2016, 'Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation: experience at a Japanese single institution', Heart and Vessels, vol. 31, no. 6, pp. 957-962. https://doi.org/10.1007/s00380-015-0694-9

Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation : experience at a Japanese single institution. / Tagaya, Manaka; Yoshikawa, Daiji; Sugishita, Yoshinori; Yamauchi, Fumi; Ito, Takehiro; Kamada, Tomohito; Yoshinaga, Masataka; Mukaide, Daisuke; Fujiwara, Wakaya; Yokoi, Hiroatsu; Hayashi, Mutsuharu; Watanabe, Eiichi; Ishii, Junichi; Ozaki, Yukio; Izawa, Hideo.

In: Heart and Vessels, Vol. 31, No. 6, 01.06.2016, p. 957-962.

Research output: Contribution to journalArticle

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T1 - Prescription patterns of oral anticoagulants for patients with non-valvular atrial fibrillation

T2 - experience at a Japanese single institution

AU - Tagaya, Manaka

AU - Yoshikawa, Daiji

AU - Sugishita, Yoshinori

AU - Yamauchi, Fumi

AU - Ito, Takehiro

AU - Kamada, Tomohito

AU - Yoshinaga, Masataka

AU - Mukaide, Daisuke

AU - Fujiwara, Wakaya

AU - Yokoi, Hiroatsu

AU - Hayashi, Mutsuharu

AU - Watanabe, Eiichi

AU - Ishii, Junichi

AU - Ozaki, Yukio

AU - Izawa, Hideo

PY - 2016/6/1

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N2 - New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 %) patients were treated with NOACs and 109 (60 %) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.

AB - New oral anticoagulants (NOACs) are now clinically available. However, few studies have demonstrated which patients with non-valvular atrial fibrillation (NVAF) actually receive NOACs in a clinical setting. We analyzed 182 NVAF patients who received oral anticoagulants. Clinical backgrounds and the risk of stroke, systemic embolism, and bleeding associated with oral anticoagulants were investigated. Seventy-three (40 %) patients were treated with NOACs and 109 (60 %) patients were treated with warfarin. A significantly lower mean number of bleeding risk factors was observed among the patients treated with NOACs than among those treated with warfarin (P = 0.010). Of the bleeding risk factors, NOACs were significantly less frequently prescribed in patients with a bleeding history and elderly subjects (>65 years) than in those who received warfarin (P < 0.001 and P = 0.029). A multivariate logistic regression analysis revealed that CHF and bleeding history were independently and significantly associated with the administration of NOACs (P = 0.047 and P = 0.003). The rate of a history of intracranial hemorrhage was comparable between the patients treated with NOACs and those treated with warfarin (P = 1.000). Significantly lower rates of a history of gastrointestinal and other minor bleeding were observed in the patients who received NOACs versus those who received warfarin (P = 0.001 and P = 0.026). NOACs were less frequently prescribed in patients with a history of bleeding, especially those with a history of gastrointestinal bleeding in a clinical setting.

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